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《原发性免疫缺陷病中每两周一次的 Hizentra®治疗:一项多中心观察性队列研究(IBIS)》。

Biweekly Hizentra® in Primary Immunodeficiency: a Multicenter, Observational Cohort Study (IBIS).

机构信息

Immunoallergology Unit, Department Medical-Geriatric, AOU Careggi, Brambilla, 3, 50134, Florence, Italy.

Department of Pediatric Immunology, Jeffrey Modell Center for Primary Immunodeficiency, University of Florence, Anna Meyer Children's Hospital, Viale Pieraccini 24, 50139, Florence, Italy.

出版信息

J Clin Immunol. 2018 Jul;38(5):602-609. doi: 10.1007/s10875-018-0528-5. Epub 2018 Jun 28.

Abstract

Immunoglobulin G (IgG) replacement therapy is a standard treatment for patients with primary immunodeficiency diseases (PIDs). Hizentra®, a 20% human subcutaneous IgG (SCIG), is approved for biweekly administration for PIDs. The aim of the multicenter IBIS study was to prospectively investigate the efficacy of biweekly Hizentra® compared with previous IVIG or SCIG treatment regimens in patients with PIDs. The study consisted of a 12-month retrospective period followed by 12-month prospective observational period. The main endpoints included pre-infusion IgG concentrations, proportion of patients with serious bacterial infections (SBIs), other infections, hospitalizations due to PID-related illnesses, and days with antibiotics during the study periods. Of the 36 patients enrolled in the study, 35 patients continued the study (mean age 26.1 ± 14.4 years; 68.6% male). The mean pre-infusion IgG levels for prior immunoglobulin regimens during the retrospective period (7.84 ± 2.09 g/L) and the prospective period (8.55 ± 1.76 g/L) did not show any significant variations (p = 0.4964). The mean annual rate of SBIs/patient was 0.063 ± 0.246 for both prospective and retrospective periods. No hospitalizations related to PIDs were reported during the prospective period versus one in the retrospective period. All patients were either very (76.5%) or quite (23.5%) satisfied with biweekly Hizentra® at the end of the study. In conclusion, the IBIS study provided real-world evidence on the efficacy of biweekly Hizentra® in patients with PIDs, thus verifying the data generated by the pharmacometric modeling and simulation study in a normal clinical setting.

摘要

免疫球蛋白 G(IgG)替代疗法是治疗原发性免疫缺陷病(PID)患者的标准治疗方法。Hizentra®是一种 20%的人皮下免疫球蛋白(SCIG),已批准用于 PID 患者的每两周一次给药。IBIS 多中心研究的目的是前瞻性研究与之前的 IVIG 或 SCIG 治疗方案相比,每两周一次给予 Hizentra®治疗 PID 患者的疗效。该研究包括 12 个月的回顾性时期和 12 个月的前瞻性观察期。主要终点包括输注前 IgG 浓度、严重细菌感染(SBI)患者比例、其他感染、PID 相关疾病住院和研究期间使用抗生素的天数。在这项研究中,共纳入 36 例患者,其中 35 例患者继续完成了研究(平均年龄 26.1±14.4 岁;68.6%为男性)。回顾性时期(7.84±2.09 g/L)和前瞻性时期(8.55±1.76 g/L)之前免疫球蛋白治疗方案的平均输注前 IgG 水平没有出现任何显著变化(p=0.4964)。前瞻性和回顾性时期的平均每年 SBI/患者发生率分别为 0.063±0.246。前瞻性时期没有报告与 PID 相关的住院治疗,而回顾性时期报告了 1 例。在研究结束时,所有患者都对每两周一次的 Hizentra®非常(76.5%)或相当(23.5%)满意。总之,IBIS 研究提供了在 PID 患者中使用每两周一次 Hizentra®的疗效的真实世界证据,从而在正常临床环境中验证了药代动力学建模和模拟研究产生的数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dd2/6061090/3f8a45f7a888/10875_2018_528_Fig1_HTML.jpg

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